can be a complex process, payroll ser- vice providers typically take care of tax reporting and other time-consum- ing tasks associated with payroll. The time savings can be substantial.” When making choices about dif- ferent HR services, Jacobs says, ASCs would be wise to do their due diligence and even consider bringing in outside expertise for assistance. “If you are considering offering a 401(k) retire- ment plan, research your options. An HR practitioner schooled in benefits and retirement plans should be able to get a good product that delivers solid, long-term returns.”

Sometimes HR decisions that do not benefit employees must be made, but these choices might be critical to the viability of the ASC. When Mala- niak started at the Ambulatory Cen- ter for Endoscopy in 2014, for exam- ple, its health insurance plan lacked a deductible, she says. “We implemented another plan with a deductible,” she says. “That allowed us to save $35,000. We made sure to have a proper rollout that included employee education so they understood why we were making the change.”

Big Picture Opportunities Jacobs says that some of the most substantial HR cost savings efforts are not as easily measured as “exe- cution-oriented” decisions like those described above. “We preach a lot about saving

money on unemployment claims costs,” he says. “ When you can keep turnover low and staff satisfaction high, people will work really well together. That leads to lower labor hours per case and lower costs per case.” Contributing to positive staff morale is a daily goal for Malan- iak. “If we can keep our employees happy, we are less likely to lose them. When you lose your best employ- ees, it affects the bottom line. When I come here in the morning, I walk around the facility and talk with all

With HR, decisions that impact your employees should be rooted in an understanding of employment law compliance. So, it is often less obvious what are the most appropriate, effective ways to save money.”

—Tom Jacobs, MedHQ

of the employees. I also maintain an open-door policy. All of my employ- ees know they can come and speak with me about any concerns.” She says her ASC also has found

great value in cross-training. “All of my staff is cross-trained now. I no longer need to rely upon per diem staff or overtime.” Post says ASCs should think of

staff retention as an effort that begins as soon as a team member joins the facility. “I believe one of the biggest misconceptions about staffing con- cerns the orientation process. Staff are often rushed into filling a position. When this happens, it can lead to frus- tration and discontent if the employee struggles to fill the role. “

Get Educated ASCs should take the time to learn rules and regulations guiding HR before making any changes, Post says. “Administrators often need to make tough HR decisions but must know how to do so while safeguard- ing their facility from potential issues such as wrongful termination lawsuits, payroll lawsuits or payroll inequities. Even the best managers probably lack training in labor law. I

cannot understate the value of pursu- ing HR education.”

When it comes to labor law, Post says, basic training is often avail- able through local colleges or online courses. “In addition, your workers’ compensation provider can probably provide cheap or even free training on the American Disabilities Act and other issues you must deal with when an employee is injured.”

She also recommends speaking with your HR service providers to learn about education they offer. “Talk with your insurance carriers, payroll providers and other agencies. If they cannot provide training, they will likely have recommendations.” With all of the important roles an ASC must fill, Jacobs says, the HR position, and its associated responsi- bilities, is sometimes overlooked or underappreciated. Doing so can have a significant effect on an ASC’s finan- cial performance. “An ASC’s costs can greatly increase or decrease depending upon how an ASC performs in the many areas of HR,” he says. “Being an HR practitioner is a long-term commit- ment to a field of study. It takes a sig- nificant amount of in-depth knowl- edge to do this work really well.”


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